Provider Demographics
NPI:1790085819
Name:SWANSON, WENDY ELIZABETH PINALES (DDS)
Entity Type:Individual
Prefix:DR
First Name:WENDY
Middle Name:ELIZABETH PINALES
Last Name:SWANSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1368 NW 123RD TER
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4318
Mailing Address - Country:US
Mailing Address - Phone:305-409-9397
Mailing Address - Fax:
Practice Address - Street 1:6890 MIRAMAR PKWY STE E
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33023-6000
Practice Address - Country:US
Practice Address - Phone:954-987-4435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-22
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN195301223G0001X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice